Will Your Health Care Advance Directive Be There When It’s Needed?

Volume: 35Issue: 4

by
James R. Silkenat

About the Author: James R. Silkenat, a partner in the New York office of the national law firm of Sullivan & Worcester and a member of its Corporate Department, is President of the American Bar Association.

My Health Care Wishes is a smartphone app that gives you and your family members the ability to store your own and each other’s health care advance directives, key health information, and health care contacts on your Apple or Android smartphones, and to send advance directive documents and other key information directly to health care providers by email or Bluetooth.

For years, the American Bar Association has preached the need for every adult to have a health care advance directive. That’s the legal document, such as a living will or health care power of attorney, that enables you to make your health care preferences clear and legally binding.

Most often, we focus on the two-thirds of adults who have yet to do an advance directive, and we tend to forget one of the big challenges still faced by those who have actually completed a directive. That’s the challenge of making sure your directive is in the hands of the right people and at the right place when it’s needed. It’s not an easy task, considering that in today’s world, we often have several physicians involved in our care – practically one for every organ of our body – and we may pass through multiple care and treatment settings during the course of an illness. So, even if you give a copy of your directive to your regular physician, there’s no guarantee it will be easily accessible in the ICU, or nursing home, or in the home health agency’s medical record.

A new smartphone app from the American Bar Association's Commission on Law and Aging helps overcome this problem in a very simple way. The My Health Care Wishes app gives individuals and their family members the ability to store their own and each other’s health care advance directives on their Apple or Android smartphones, and to send the documents directly to health care providers by email or Bluetooth. It also stores and can send other key information, such as contact information for your health care agent, key family members, and physician, as well as important medical and insurance information.

You might think of the app as a kind of personal advance directive registry. Registries have been around for a while, operated either by state agencies or private organizations. But registries normally store documents on a central server and make them available to medical providers on request through cloud-based systems. None of the existing registries have ever attracted a truly critical mass of participants. The ABA’s Commission on Law and Aging concluded that many people are simply reluctant to give up control of such personal documents to a third party and to an electronic environment they don’t personally control. This in turn triggered the idea for the app which allows users to create and manage their own “registry” right on their smart phones.

How Can It Help?So how would this app make a difference? Let’s suppose a friend named Sandra has an aging father who lives on the East Coast and enters a hospital with a very serious condition. He is unable to make decisions for himself. Sandra lives in the Midwest. The hospital notifies her of the admission and asks if her father had appointed a decision-maker or has an advance directive. Sandra’s father did indeed create an advance directive naming Sandra as his health care agent. Fortunately, Sandra has her father’s advance directive on her smartphone, and she immediately emails it to the hospital.

The app has also stored other vital information about her father’s medical condition, physician and specialists, and his health insurance, which she also emails immediately, without having to search her home files for documents or other health information. If Sandra’s father had been mentally capable when he entered the hospital, he too could have provided his advance directive to the hospital through his own smartphone by email or Bluetooth connection.

We all hope we will never need to use an advance directive, but when it’s needed, making it accessible is so very important. The full version of the app, which costs $3.99, is described as a “personal and family advance directive manager.” A lite version of the app is free and stores only one person’s advance directive information.

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